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11970 SW HAZELWOOD LOOP ii�.n f�../ �•.a Cdr ' `. 11970 SW HA7ELWOOD ••' i t , r q_. r 1 �f • • i • • .j cn VA r City of Tigard Mechanical Permit New Installation ❑ Replace ❑ Relocation❑ Addition ❑ Alteration U DATE: HEATING CONTRACTOR * _ OW,'IER „z ADDRESS_— __ JOB ADDRESS__ _.__.-_. == -�— �PHONE __ _,.. APPLICANT __._—_.__-.___-_.__ __� Heat In,out Rating(BTJ per Hour) Vent Size FUEL OIL❑ GAS © ELECT ❑ OTHER - - ITEM N`_. PEE _ ITEM NO. FEE J _ -_ _ _ Fcr Issuance of Permit SEE BELOW_ Each Air Handling Unit or Duct System 7;50 New-up to & incl, 100,000 BTU 6.00_ Commercial Hood System 7.50 New 100 000 BUT's & over _ __i.50 Other Equipment Each 4.50 Woodburning Stove _ 4.50 1 Trip Inspection _ 4.50_ _Wall-rloor• Suseended a` �— 6.00 Air Condition Corepressor - up to&:nrl.3 H_°. _6.07 Vent S_atomw./Fan 4.50 Air Condition Comressor-3.1 to 15,H.P.incl. 11.00— F pair Hem Cooling —� 8.00 --'' CITY BUSINESS LICENSE REQUIRED BYALL CONTRACTORS OR SUB•,.ONTRACTOR5 ! ! PERMIT ISSUANCE 10.00 Comments: FEES % STATE Issued _- 25%PLAN CHIS•C� TOTAL��, P;' REC. # Signature of Applicant ,C�•'V, •}+ 74 ,F?iaK 'vaN +FtIP� �!'^'r "'�°r �7+/ '"w'i+' �/�> ,/ '•, / / 3' 'ra of r< w•. N w r, r•..r a �•y y.v. d � ./ rr✓ w•r Jr w v r v w -w .r �r�! 'L : � .• .. n.._^•_:^.A(.RRRT.RT.T.',!#A� -. _ YYI.I � T.•—"M1C'4.0.17�f..'i'�' l"' _ _ _- ... �<w OF' ore CITY OF TIGARD OREGON ! _. .Art Lutz...�..�.o......................................Permit No.......1214..... U«ner: Building Address......11970 W Hazelwood Loop.•..............................I....... . ..... . .............. 19....77. Certificate It3 hereby given this...2. .4. ...day of....N. Y..... ... that said Building ioay be occupied and (, that it complies with all requirements of the Building Code for the City of Tigard, .jz approved by the Tigard City Council. y �' L. . .......................... Building Inspector r ' � �4 T L1 s»j 1C=- C•) ' i' »* Al. �»--'b t. j►w> �1 Z* U r� 'J • \1( 4=1+. U C, 171, 1 Yl X!1.7 rsp,t �:. \'4 ���ip�7 , Ij+ war w i , Cstu of Tigard INSPECTION REQUEST i for �.�. w INSPECTIOi4 TIME: a.' PERMIT NO. : - - . DATE: .2 /h' /72 DATE ISSUED ._..1..1 I _f OWNERS NAME " l--- ADDRESS: CONTRACTOR : r'f_ST : Air 0, Water n , Vieth 0 , Lobrorawy cl 9ESULT: Approved [7 Disapproved r , Funding [a SKETCH. I� I 1 I pffs,_PECTOR DATE NOTE: Attach aupvl#mento teat data bei etoo 1 91 UNIFIED SEWERAGE AG" ENCY NO. 11032 WASIHING"JON COUN-FYDATE 12-21-76 CITY 0F-- ji_qa r dl APPLICATION FOR bEVVLR CONN[-CTION PERMIT OWN r R: ­. ---- Art Ltitz—Co-,--_._-_- --.__-.__ ________ _.._--....______ . __ ___ _ OWNER'S -,------- OWNER'S ADDRESS: STREET City STATE BUILDING SITE: LOT BLOCK ­ ADDITION TAX LOT NO. 'TYPE OF OCCUPANCY ADDRESS - -- .- A-19.70-5V H-aze.1wood, Loop DWr-LLING UNITS- FIXTUIZIE UNITS ----- SURCH.�P61E IF APPLICABLE .-......____— PF RMiT FEE _ 575.­Q0---.--­- INSPECTION FEE 25.,OG..- TOTAL DEPOSITED (NEW) (EXIST ING) BUILDING SEWER SYSTEM -. .. .. .F.anna.-Cr-sek---­ The Applicant agrees to comply with JI rules and regulations of the Unified Sewerage Ajency. APPLICANT­. .7, SEWER PERMIT THIS PERMIT AUTIA0131ZF-S CONNECTION TO THE SEWER SYS1 EM. LINE SIZE INSTAL LER RECEIVED • (AGENCY OR ITS A(,'(NT) CONIMFNIS: Bldg. #1214 This Application and permit expires in one hundred and twenty ( 120) days. The amount paid will be forfeited should expiration occur. BUILDING PERMIT APPLICATION 1oF 12-21-76 T�GARC� DATE_, , 19___. 1 H UNDERSIGNED HEREBY APPLIES FOR ,PERMIT FOR THE WORK HEREIN INDICATED BUILDEhPHONE 2A2�-4p 7 ' OR AS SHOWN AND APPROV'D IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONF LOT NO.. rt Lutz Co. OWNER JOB ADDRESS � ! �i' � i..:� 6146ME ADDRESS ARCHITECT 1) amq ENGINEER GUILDER ADDRESS _ DESIGNER StRUC7URc X IJNEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION RESIDENCE [:]COMMOMM ❑EDUCATIONAL_ ❑GOV'1 ❑RELIGIOUS❑PATIO ❑CARPORT []GARAGE ❑STORAGE❑SLAB []FENCE ❑BOND 0MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL.APPROVED ❑SIGNS _ --- - I — R-7 -- 1A -- 3 —--- , Tl,a OCCUPANCY- LAND USE ZONE _BLDG.TYPE .FIRE ZONE-- PLAN CHECK BY--- HEAT cone t. sintjle family ddel.Lxnq u/atbechad 4 bedroom 2 beth 4101 1 1.441 33,700. QCC. LOAD----- FLOOR LOAD HEIGHT -NO.$TQRIE$ ASZEAN2@EDROCIM$ YALUF- - BUILDING DEPARTMEN' SET BACKS FRONT 2C REAR 34 LEFT SIDE 10 RIGHT SIDE 20 Permit 13- ..0 ---- - ' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE NUILOING CODE, ZONING Plan Check � � d REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 11 IS HEREBY AGREED THAT THE WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECiFICATIONS AND IN COMPLIANCE WITH SUb•total ALL- APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVF 47 RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY RUSINFSS State Tax LICENSF. SEPARATE PERMITS REGOIRED FOR SEWER, PLUMBING AND HEATING Total 1 3.47 By APPI '-ANT OR AGENT Approved "� Receipt No W 11111171 DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE /• � U �"Y�� — Contractor ��, -8 °^r^.;t No. (A' �7 SS _ -;:-/7 rp, V ! Rough-in 1.r•., „ .�. %• % Fixture -- f s Final 5671 N HEATING Contractor 1 Permit No. 66` Gas or Oil Rough-in —_-- -�, Final _ SEWER ^ Final _ DRIVEWAY _ Final --_____ Storm Drainage (Rain Drain) Final Sidewalk Curb&Street Final A roach BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY Final Landscaping ` ( Zoning Final \._ � 3 woor.� oocC� C7oc r_i U LLI `i.', �� k.) r coil r; � ui CN ,, Li i R .%- LL • u_ C i Ll g LL U O {L d o o U O f LL) z 0 2 03 ° Q d a. woo_ Ca °o N fr M } ~ �,I c c ay, E c u -� O r 7 a: ` rs r=� 0 yri E ' A f O a "L = c c 3E E to p o C o w mQQw » soU0 C t I cc ❑ cu _ J C r_ Q > 4 d 0 0 o, o o 0 0 o 0 0 0 LLl000aool � ou� Uv f- w m v In v v N a v r� 0 ul 4 w w - v y � •:� ( S J 1-- Z 0 O J O p w 0 CL }— �� ❑ ° a C!3 ° - - 0 cc 7; i w t; � (� d 43- d �ll s ui JA A � ' ] ti m 1n d m < � � a O z C-1-- ►il a N m F- c wVi cc m u oZ, ❑ F- o o a vl a3 M r cn w m CC a a` u n a v O O IL Z D U E v .0 O O c`n w J_ c : p T c " Lo o O H a uc a 0 O O ci LL > 4 W U m 0 cl a III 0q 0 w �. U 7 N — - In F- a. Ill n `../ I Lb) Q a .t LL U, z = rr m m° m m° �� d cc n EPW KM Address rPermit No. Permit charge ;�2 4) � Owner ` Connection fee 5 Paid by Type of buildingDate connected r'4 Service rate �' Inspection fee Contractor Paid by Date Size of connection Assessment ^� paid i